Kornimate/medical-research-clean huggingface dataset:
diabetes prevention in estrie

Conditions: Overweight; Glucose Intolerance

Summary: this study compared the efficacy at one year of an interdisciplinary approach including individual counseling and group seminars versus group seminars alone to induce weight loss in subjects at high risk of developing type 2 diabetes. this study also compare if a participant's presence in small informative meeting groups as the only form of intervention is sufficient to induce a lifestyle change, thus inducing the weight loss needed for the prevention of the diseases associated with obesity.

eligible participants will be randomized into 2 intervention groups (30 per group): 1. small meeting groups: a curriculum of 25 meeting-seminars will take place for 45 minutes, each one approaching various aspects of nutrition, physical activity, psychology, motivation and medical needs. these seminars are administered by the professionals of the obesity clinic and are already in place. however, these are usually only offered to the patients registered with the obesity clinic. 2. obesity clinic of chus: combination of 25 described meeting-seminars see-high, in addition to individual interviews every 6 weeks with the interdisciplinary team of the obesity clinic of chus (usual operation). subjects will be evaluated initially and then every 3 months during 1 year by the following measurements: questionnaires to evaluate motivation and physical activity; 3 day dietary journals; weight assessment, using both metabolic and mechanical balance; waist circumference; and blood pressure. a medical evaluation with size measure, a test evaluating knowledge of the participants on obesity, ogtt (oral glucose tolerance test) - a 5 hour determination of secretion and resistance to insulin, insulin-mediated suppression of plasma non-esterified fatty acids, a plasma lipid profile, accelerometry, bio electric impedance, and an activity physical test (6 minute walk test) will be carried out initially, and then repeated for up to 1 year.

Eligibility criteria:
inclusion criteria: * pre diabetic state underlined by a marginal fasting glycemia between 6,1 and 6,9 mmol/l and/or a glucose intolerance with glucose confirmed by an ogtt 2 hours * overweight or obesity (bmi \> 27 kg/m² ; (body mass index)) * enlightened assent exclusion criteria: * impossibility to be present at the visits * physical/motor incapacity (or other) making one unable and/or insecure to walk at a moderate to rapid speed of 6 min and more * use of an anti-obesity treatment during the last 3 months * bariatric surgery in the past * planned pregnancy * pacemaker

Keywords: overweight obesity glucose intolerance pre-diabetes
improving utilization of supplemental breast mri screening for women with extremely dense breasts

Conditions: Breast Cancer

Summary: the goal of this study is to increase mri utilization among women with extremely dense breasts. the main question it seeks to answer is whether nudging of the provider, patient, or both increases the uptake of mri among this group, and whether this effect differs between black and white women.

women with dense breasts have 3-5-fold increased risk for breast cancer as women without dense breasts. dense breast tissue can "mask" small tumors, leading to reduced mammography sensitivity. recent randomized controlled trials demonstrate that supplemental breast mri screening improves detection of small, invasive cancers that are not detected by mammography. in january 2022, a pennsylvania law went into effect mandating insurance coverage of supplemental screening for women with extremely dense breasts. currently only a small fraction of eligible women with extremely dense breasts are receiving supplemental breast mri screening. clinical pathways to identify patients who are eligible for insurance coverage of supplemental breast mri screening and communicate this option to patients and providers are needed to ensure equitable access to supplemental screening. this study therefore proposes a stepped wedge cluster randomized clinical trial to determine whether electronic health record (ehr) and secure text message nudges increase utilization of supplemental breast mri screening among eligible women with extremely dense breasts.

Eligibility criteria:
patient participants: inclusion criteria: * women aged 40-74 * recent non-actionable mammogram of less than 6 months * mammogram performed at penn center for advanced medicine, penn presbyterian hospital, pennsylvania hospital, or radnor * valid mobile phone number exclusion criteria: * prior history of breast cancer * no breast mri within the past 2 years * no prior actionable mammogram within 6 months * no recent or concurrent ultrasound provider participants: inclusion criteria: * provider needs to have ordered the initial screening mammogram * employed by penn health system and access to penn chart

Keywords: breast cancer breast density mammography
a novel formulation of pasteurized maple cough syrup compared with placebo on nocturnal cough and sleep quality in infants with upper respiratory infection

Conditions: Cough; Upper Respiratory Infection; Nocturnal Cough

Summary: cough is a frequent symptom in children and infants and is one of the most common reasons parents visit a healthcare provider for their child. the us food and drug administration has issued a warning that over-the-counter cough and cold medicines including antihistamines, decongestants, anti-tussives, and expectorants should not be administered to children younger than 2 years of age due not only to lack of proven efficacy, but also because of important safety concerns. a product that has been used in alternative medicine for cough is maple syrup. although no studies have formally evaluated the use of maple syrup for nocturnal cough associated with uri, the demulcent effect of maple syrup may provide some relief from cough in children. a novel formulation of pasteurized maple cough syrup, when compared to placebo, should provide superior relief on nocturnal cough and the sleep difficulty associated with uri in children under 12 months and sleep difficulty of their parent/caregiver.


Eligibility criteria:
inclusion criteria 1. otherwise healthy male or female infant who is between 0 and 12 months of age. 2. presents to clinic with a uri characterized by the presence of rhinorrhea and cough for 7 or fewer days' duration. 3. patient is an appropriate candidate, in the judgment of the investigator, to participate in the study. 4. parents/caregivers provide an answer of at least "somewhat" (3 points on a 7-point likert scale) for a minimum of 2 of the 3 questions related to nocturnal cough frequency, effect on child's sleep, and effect on parental/caregiver sleep based on the previous night's symptoms (see section 11.0). 5. parent/legal authorized representative provides written informed consent for child to participate in study. 6. parent/caregiver who is willing and able to comply with study requirements. exclusion criteria 1. signs or symptoms of a more treatable disease (eg, asthma, pneumonia, laryngotrachebronchitis, sinusitis, allergic rhinitis). 2. diagnosis of influenza, bronchiolitis or respiratory syncytial virus (rsv). 3. history of reactive airways disease, asthma, or chronic lung disease. 4. use of any medication to treat cough within 6 hours of bedtime on the evening prior to or on the day of enrollment. (use of analgesic medications such as acetaminophen or ibuprofen is not exclusionary.) 5. presence of any significant disease including immunodeficiency, hepatic, renal, cardiovascular, or hematologic disease or any other health condition that, in the opinion of the investigator, would preclude participation in the study.
hybrid interactive avatars for post-covid sufferers

Conditions: Post-Acute COVID-19 Syndrome

Summary: the goal of this observational study is to evaluate an app to improve communication and information flows for persons suffering from post-covid-19 syndrome (pcs). the main questions it aims to answer are: * how can custom virtual characters (avatars) help to collect more data for the diagnosis of pcs? * can conversations with virtual (mobile) characters (avatars) and the presentation of health data help to improve the diagnosis and understanding of pcs? * how should these virtual characters (avatars) be designed for people with pcs and healthcare professionals to be useful in the long term? this concerns appearance, dialog, personality and functions. participants will be asked to use and test the app and take part in two interviews at the beginning and end of the study.

the overarching goal of the hint project is to develop an app that people affected by pcs can use on their own devices in a language of their choice (e.g. their native language) to increase their health and data literacy about pcs and to provide socially equitable access to pcs care. multilingual avatars are used for independent data collection, as the embodiment of interaction systems offers advantages for health queries. the data collected during the survey and - if desired - data from wearables are combined with historical data from the participants, processed and visualized. this allows patients to communicate with their avatar as well as with medical staff about their illness and its progression without language barriers affecting treatment. the avatar can also inform patients about new research findings on pcs. to this end, the system's level of knowledge is constantly compared with the current state of science; new findings are prepared for the target group and added to the knowledge base. the project is aimed at all those affected by pcs, although the multilingualism and low-threshold health education are intended to appeal in particular to people who have previously had difficulty accessing adequate care. the project is aimed at all those affected by pcs, although the multilingualism and low-threshold health education are intended to appeal in particular to people who have previously had difficulty accessing adequate care. the participatory and iterative development of the system, which also involves medical staff, contributes to overarching issues relating to co-creation approaches in the healthcare sector.

Eligibility criteria:
inclusion criteria: * existence of a declaration of consent * stable clinical condition * diagnosis of post-covid syndrome according to the world health organization (who): * symptoms persist for more than 12 weeks * duration: at least 2 months * etiology: no alternative diagnosis * progression: persistent, recurrent, fluctuating exclusion criteria: * known psychiatric or somatic illness that can explain the symptoms

Keywords: post-covid-19 syndrome avatar app development
treatment strategy for alcohol use disorders in veterans with tbi

Conditions: Alcohol Dependence

Summary: the purpose of this research study is to understand the effectiveness of valproate (a common mood stabilizer) to further reduce alcohol misuse when given in addition to attending an alcohol rehabilitation program as well as the treatment of mood disorders or ptsd. the main goal of this project is to understand if people receiving valproate will have a better recovery than people receiving the standard treatment for alcohol dependence: naltrexone.

veterans are vulnerable to develop complex forms of addictive disorders characterized by the presence of traumatic brain injury and psychiatric conditions such as post-traumatic stress disorder and mood disturbances. alcohol use disorders are frequently observed among veterans and exert a detrimental effect on community reintegration after deployment. attending to this veteran health problem, the va is devoting extraordinary efforts to develop adequate treatment strategies. in this study we will evaluate treatment outcomes and identify specific factors that influence alcohol use disorders treatment response in a va intensive outpatient program offering rehabilitation treatment to the growing number of veterans with alcohol use disorders. cooperation between researchers and clinical staff will allow optimizing treatment strategies that enhance the recovery of veterans with alcohol use disorders.

Eligibility criteria:
inclusion criteria: * veterans attending alcohol use disorders rehabilitation treatment within the va * presence of a diagnosis of alcohol dependence according to dsm-iv * a history of heavy drinking * absence of withdrawal symptoms exclusion criteria: * evidence of other substance abuse different from nicotine or cannabis (dsm-iv criteria) or by 2 consecutive positive urine drug screens * unstable medical conditions such as severe heart disease, liver or renal failure or evidence of neoplasia. * liver enzymes (alt, ast) serum levels \>3 times the upper limit of normal * unstable psychiatric conditions that requires treatment in a more structured setting (i.e. active si, worsening psychotic symptoms or acute mania) * diagnosis of schizophrenia or schizoaffective disorder * requiring therapy with valproate or naltrexone or has a history of significant side effects from either study drug * requiring therapy with topiramate, lamotrigine or carbamazepine * requiring chronic treatment with opioid analgesics for refractory pain * failed 3 previous intensive alcohol rehabilitation programs in the past 2 years * females

Keywords: alcohol use disorders traumatic brain injury mood and anxiety disorders
to compare postoperative horizontal position stability of the ct lucia 611p and the ct asphina 409mp

Conditions: Cataract Senile

Summary: the main objective of the trial is to assess the efficacy of the ct lucia 611p intraocular lens (iol) with regard to the horizontal iol position stability. the horizontal position collected at 1 month and 4 to 6 months post-operatively will be compared to the horizontal iol position recorded at baseline (1 week post-operatively) as well as to the position stability of the reference iol, ct asphina 409mp.


Eligibility criteria:
inclusion criteria: * patient informed of the consequences and constraints of the protocol and who has given his/her written informed consent; * patients of any gender, aged 50 to 90 years; * assured follow-up examinations; * healthy eyes besides clinically significant bilateral age-related cataract. * distance corrected visual acuity ≤ 0.3 logmar normal findings in the medical history and physical examination * calculated iol power within the available dioptre range; * biometry measurement/cataract density compatible with the iolmaster evaluation. per operative inclusion criteria: * iol implanted in the capsular bag; * the 2 iol models (ct lucia 611p and ct asphina 409mp) have been implanted in the 2 eyes of one patient; * no intraoperative complications; no damaged capsular bag, no intraocular haemorrhage; no can opener rhexis. exclusion criteria: * allergy to heparin * monophthalmic patient * ocular disorders, other than cataract, that could potentially cause future acuity loss to a level of 0.20 logmar (best-corrected) or worse in either eye; * any anterior segment pathology that could significantly affect outcomes (e.g. chronic uveitis, iritis, corneal dystrophy, etc.); * floppy iris syndrome; * diabetic retinopathy; * traumatic cataract; * aniridia; * microphthalmus; * amblyopia; * degenerative visual disorders (e.g. macular degeneration, optic nerve atrophy, or retinal disorders); * patient expected to require retinal laser treatment before the end of the last follow-up; * previous intraocular and corneal surgery; * expected postop. astigmatism greater than 1 d; * any type of corneal disorder; * dementia; * pseudoexfoliation syndrome (pex); * glaucoma or iop higher than 24mmhg under ocular hypertension treatment; * any other pathology or condition presenting, according to the investigator opinion, a risk for the patient. * pregnancy and/or lactation
inflammatory markers for postoperative complications in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Conditions: Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy

Summary: infective complications after cancer surgery had a significant impact on disease-free and overall survival. postoperative inflammatory markers have been proven useful in predicting infective complications. however, it remains unknown whether these markers can predict postoperative infection in patients receiving cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (hipec) which causes the systemic inflammatory response syndrome. between september 2014 and april 2017, all patients who underwent cytoreductive surgery and hipec for peritoneal carcinomatosis were assessed for postoperative complications. patients were divided into two groups according to the presence of infective complications. presence of abscess, positive blood, surgical site, urine or sputum cultures, or clinical signs and symptoms with comparable radiologic findings were defined as infective complications. retrospectively, c-reactive protein (crp), neutrophil-to-lymphocyte ratio, white blood cell count, platelet count, mean platelet volume, platelet-to-lymphocyte ratio, albumin were collected from preoperative day and postoperative days (pod) 0-14.


Eligibility criteria:
inclusion criteria: * between september 2014 and april 2017, all patients who underwent cytoreductive surgery and hipec for peritoneal carcinomatosis exclusion criteria: * a patient treated the dexmedetomidine.
the impact of covid 19 pandemic on ureteric stents complications.

Conditions: Determine Effect of Urological Malpractice During Covid 19 on Patient Complications

Summary: the pandemic of coronavirus disease 2019 (covid-19) has serious implications on urology practice and raises particular questions for urologists about the management of different conditions. it was recommended to cancel most of the elective urological surgeries. (1) the least invasive intervention modalities that can be completed in local or regional anesthesia will serve the best interest of patients and urologists. 10 14 endoscopic surgery is considered relatively safe.(2) after end of pandemic we facing complication of this era, one of most common complication was jj stents complications as most of patient and doctors prefers to defer most of elective management by just jj insertion and postpone definitive treatment. (3) in this study we discuss retrospectively the complication of jj stenting during covid 19 pandemic.

type of the study: retrospective clinical study * study setting: qena university hospital 3- study subjects: a. inclusion criteria: all patients performing jj stent placement during covid 19 pandemics b. exclusion criteria: patients refuse to participate in this study c. sample size calculation: all patients performing jj stent placement from march 2020 to december 2021 * study tools (in detail, e.g., lab methods, instruments, steps, chemicals, ...): * medical history * complete physical examination. * all patents presented was investigated by 1. abdominal u.s 2. plain x ray 3. non contrast ct 4. serum creatinine 5. urine analysis * research outcome measures: 1. primary (main): determine effect of urological malpractice during covid 19 on patient complications 2. secondary (subsidiary): determine jj stent complications during covid 19 pandemics

Eligibility criteria:
inclusion criteria: * all patients performing jj stent placement during covid 19 pandemics exclusion criteria: * patients refuse to participate in this study

Keywords: urological stents , covid19
comparative study of sharkskin versus grieshaber forceps during ilm peeling

Conditions: Epiretinal Membrane; Macular Holes

Summary: the purpose of this study is to compare the performance and anatomic outcomes of the sharkskin internal limiting membrane (ilm) forceps and the grieshaber ilm forceps in macular surgery. peeling of the ilm is a difficult aspect of vitreoretinal surgery and often daunting task from a vitreoretinal fellow's perspective. the hypothesis is that the newer sharkskin forceps have a larger platform and micro-abrasions along the forcep surface to increase grasping ability and potentially limit trauma to the retina surface compared to the grieshaber forceps. this project may also serve as an education tool for fellows learning the basics of ilm peeling.


Eligibility criteria:
inclusion criteria: * macular pathology exclusion criteria: * no prior vitreoretinal surgery
clinical outcomes from treatment and evaluation of obstructive sleep apnoea in children with down syndrome

Conditions: Obstructive Sleep Apnea; Down Syndrome; Quality of Life; Behavior; Adherence, Treatment

Summary: the goal of this observational study is to learn about the use of non-invasive ventilation for treatment of obstructive sleep apnoea syndrome in children with down syndrome. the main questions it aims to answer are: * what is the impact of non-invasive ventilation on sleep behaviours and quality of life? * what barriers are faced by children and their families in establishing tolerance to non-invasive ventilation? participants will be asked to complete questionnaires before and after starting treatment. researchers will compare this data with the results of sleep studies and non-invasive ventilator downloads recorded as part of standard medical care. a sub-group of up to 20 participants will be invited to take part in 45-60 minute interviews exploring expectations, experiences and barriers encountered during non-invasive ventilation therapy.

our aim is to examine the impact of non-invasive ventilation for treatment of obstructive sleep apnoea syndrome in children with down syndrome on behavioural and quality of life outcomes and to establish the specific barriers experienced in establishing adherence to treatment. information from clinical assessment, sleep studies and device downloads recorded as part of standard care will be combined with questionnaire data to assess for changes in behaviour and quality of life. all participants will undergo questionnaire assessment of barriers experienced. a sub-group of up to 20 participants will be invited to take part in 45-60 minute semi-structured interviews exploring expectations, experiences and barriers encountered.

Eligibility criteria:
inclusion criteria: * individuals with a confirmed diagnosis of down syndrome where a clinical decision has been made to initiate respiratory support with non-invasive ventilation. * obstructive apnoea hypopnoea index \> 2 episodes/hour or where sleep disordered breathing symptoms occur in combination with an apnoea hypopnoea index \> 1 episode/hr. - english language proficiency. * age ≥ 4 months at the commencement of therapy. exclusion criteria: * individuals not willing to comply with study procedures or assessments. * individuals for whom ventilatory support devices are already prescribed and those with artificial airways. * individuals on clinical trials of investigational support therapies.